This invention relates to a surgical procedure specifically joint procedures involving arthroscopy, i.e. Knee and shoulder.
Physicians practicing surgical procedures known as xe2x80x9cArthroscopyxe2x80x9d, must insert a cannula for an Arthroscope. Attached to the Arthroscope is a camera that projects an image to a monitor. Examination of the joint; knee, shoulder, ankle or wrist, is performed and decision is made to repair or remove any pathological problem associated with or in the joint. An egress drain is then established so the joint may be filled with fluid, Sorbitol(copyright) or Glycine(copyright), creating a working field. Depending on what pathological problem is presented during examination, the necessity may arise to xe2x80x9cshavexe2x80x9d, xe2x80x9cburxe2x80x9d or evacuate the joint to repair the pathological problem.
An Arthroscopic Shaver or Bur commonly referred to as a xe2x80x9cSoft-tissue Cutterxe2x80x9d is employed to cut, trim or burr damaged cartilage, degenerate bone or damaged tendons and/or tissue.
A tourniquet is applied to the upper thigh to reduce bleeding in the knee, ankle or foot, upper arm to reduce bleeding in the elbow or wrist, but cannot be employed during shoulder arthroscopic procedures. Debriding the joint (any joint) may cause bleeding. Current means of coagulating bleeding in the joint is time consuming and inconvenient to a physician with a patient under anesthesia. Coagulation is achieved by removing the debriding apparatus (shaver or bur), re-entering the joint with an elongated probe, hooked at a 90xc2x0 angle at the working end, attaching that probe to an electro-cautery machine, irritating the joint to visualize the point of bleeding, and touching the bleeding area with the electrified elongated probe. When the hemorrhage has been abated, the elongated probe is removed, the debriding apparatus (shaver or bur) is replaced, the joint is again irrigated and the surgical procedure is resumed. If hemorrhaging occurs again the process is repeated until the hemorrhaging has ceased and the procedure can be completed.
Utilizing this method of coagulation is effective, but inconvenient, time consuming and potentially damaging. A patient under the influence of anesthetics is at risk and any and all time saving measures are necessary to decrease the related health risks of being under anesthesia. The inconvenience of removing the debriding apparatus, irrigating the joint and re-entering the joint with another instrument is time consuming and potentially dangerous to the welfare of the joint. Damage to tissue, tendons, bone and cartilage may occur upon re-entry of either the probe or debriding apparatus (shaver or bur). Each time either apparatus is removed and re-entered more time elapses and the patient is subjected to increased anesthesia time and associated risks of being under the influence of anesthetic drugs and gases.
Objects and advantages of the Arthroscopic Cautery Sheath invention are:
(a) provide a single entry point for debridement and cauterization of bleeding during arthroscopic procedures.
(b) to decrease medical costs both in time and supplies:
(1) time: not having to exit and re-enter the joint with each apparatus accomplishing surgical repair and or coagulation with the same instrument
(2) supplies: the sheath houses both the debriding and coagulation apparats.
(c) to decrease surgical and anesthesia time for the patient undergoing an arthroscopic procedure.
(d) to provide a safe and effective means of coagulation of hemorrhaging during arthroscopic surgery.
(e) to provide the physician with a competence of being able to debride, irrigate and coagulate during a surgical arthroscopic procedure without exiting and re-entering the joint multiple times.
Further objects and advantages are to provide an instrument which is user friendly and convenient for the physician""s use during arthroscopic surgical procedures. The electrical current delivered from the electro-cautery machine is delivered down the external stationary metal tube of the debriding instrument(shaver or bur). The current can then be directed at the hemorrhage site without having to exit the joint or interrupt the surgical procedure by changing instrumentation. Manufacturing costs are minimal and the instrument is totally disposable following arthrosocpic surgical procedures. Single patient use prevents patients from risk of cross-contamination.